Boris Klempa Department of Virus Ecology Institute of Virology Slovak Academy of Sciences Bratislava, Slovakia
Yosemite Hantavirus Outbreak August, 2012
source: Robert-Koch-Institute, Berlin
Puumala Dobrava-Belgrade Sin Nombre Andes Hantaan Seoul H F R S H C P S hemorrhagic fever with renal syndrome (HFRS) case fatality rate of up to 15% hantavirus cardiopulmonary syndrome (HCPS) case fatality rate of up to 50% Sangassou Tanganya Azagny Magboi Mouyassue Klempa et al., Emerg Inf Dis 2006; 2007 Klempa et al., J Inf Dis 2010 Klempa et al., J Virol 2012 Weiss et al., 2012 H C P S
200, ,000 cases annually , hemorrhages fever renal dysfunction Ferluga D, Vizjak A JASN 2008;19: ©2008 by American Society of Nephrology
biosafety level 3 or 4 conditions slow growth on cell cultures no detectable CPE on cell cultures no reverse genetics no animal model virus detectable in patients only very shortly after clinical onset
1. Step 2. Step Genus specific PCR Sequencing Phylogenetic analyses Recombinant antigen expression for serodiagnostics Primer design for specific PCR Neutralisation assay for serotyping Comparative pathogenesis studies Virus isolation in cell culture
DOBV is present in Central Europe in Apodemus agrarius and forms a separate DOBV-Aa lineage Klempa et al., J Virol 2003 DOBV-Aa causes HFRS Klempa et al., J Clin Microbiol 2004 DOBV-Aa cell culture isolates allow fine-serotyping and comparative pathogenesis studies Klempa et al., J Clin Microbiol 2005 Klempa et al., Emerg Infect Dis 2008 Kirsanovs et al., Virus Genes 2010 Popugaeva et al., Plos ONE 2012 Apodemus flavicollis A. agrarius
% of patients (n = 36) average duration: 6.8 days Abdominal pain 81 Vomiting 62 Diarrhea 42 Facial flushing 73 Haemorrhagic sclerae 54 Oliguria <500 µl 85 Increased blood urea, creatinine 85 Acute onset, fever100 Case fatality rate 16.7 ! Observation New DOBV lineage discovered in Apodemus ponticus Dzagurova et al., Clin Infect Dis, 2012 Isolation from a fatal HFRS case Apodemus ponticus Klempa et al., Emerg Infect Dis, 2008
0.1 Cao Bang Jemez Springs Seewis Ash River Seoul Hantaan Dobrava Sangassou Puumala Tula Andes Sin Nombre Thottapalayam Arvicolinae- associated Sigmodontinae- associated Murinae- associated Hylomyscus simus Sangassou, Guinea Klempa et al., Emerg Infect Dis 2006 Soricidae- associated Tanganya Tanganya, Guinea Crocidura theresae Klempa et al., Emerg Infect Dis, 2007
Klempa et al., J Inf Dis 2010 Seroepidemiological study in Guinea recombinant N protein expression ELISA immunization immunofluorescence test neutralisation assay (FRNT) Klempa et al., J Virol 2012 Comparative pathogenesis study uses ß1 integrin as entry receptor is a strong inducer of IFN- λ in type I IFN-deficient Vero E6 complete genome sequencing unique properties within Murinae- associated hantaviruses
89 0,2 SEOV DOBV SERV HTNV ANDV MAPV RIOMV CHOV SNV LNV TULV PUUV VLAV TPMV NVAV ALTV MJNV MGBV ARRV JMSV CBNV RPLV SWSV ARTV KKMV OXBV ASAV Muridae- associated Cricetidae-associated Soricidae-associated Talpidae-associated Soricidae-associated Talpidae-associated Nycteridae-associated TANGV SANGV Magboi virus Nycteris hispida Sierra Leone Weiss, Witkowski et al., Emerg Inf Dis 2012
still have a potential to emerge: new virus species in new natural hosts in new geographical regions during new outbreaks
Michal Stanko Marta Siebenstichová Zuzana Gulášová Martina Ličková Lukáš Radosa Institutes of Virology and Zoology, Slovak Academy of Sciences Bratislava, Slovakia Detlev H. Krüger Brita Auste Peter Witkowski Andreas Rang Institute of Virology, Charité Berlin, Germany Jan ter Meulen Emilie Lecompte Philipps University Marburg, Germany Lamine Koivogui Viral Hemorrhagic Fever Project Conakry, Guinea Elisabeth Fichet-Calvet Christiane Denys Museum National d'Histoire Naturelle Paris, France Fabian Leendertz Sabrina Weiss Robert Koch Institute Berlin, Germany Christian Drosten Jan Felix Drexler Bonn University, Germany VEGA Evgeniy A. Tkachenko Tamara Dzagurova Chumakov Institute Russian Academy of Medical Sciences, Moscow, Russia